Healthy Skepticism Library item: 1674
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: news
Spencer C.
Everyone gets to know about prescriptions -- except the patient
The Ottawa Citizen 2002 Feb 11
Full text:
Some months ago, I started subscribing to a “health” newsletter.
Naturally, I now receive bizarre mailouts on herbal supplements,
personal massagers, deluxe air-purifiers — even coupons for a
California clinic. My favourite is the pamphlet promising to reveal why
doctors don’t get sick; for a fee, it will share the secret remedies
they’re holding back.
As you can see, my mailbox overflows with medical trash-talk.
Fortunately, there are also authentic wellness newsletters, and I get
some of them. But then, I’m an intelligent sort, able to sort the wheat
from the chaff. You aren’t. You’d probably read the snake-oil pamphlets, buy the instant cures and hurt yourself. Society must ensure you are not exposed to all
that hyped-up health gunk.
That, friends, is the sort of paternalistic prism through which
governments see health care: You can’t sort things out so we’ll do it
for you. And nowhere is this paternalism clearer than in the ruckus over
direct-to-consumer advertising of prescription drugs.
Because you cannot be trusted to make informed decisions about your
health — or even to ask good questions — the government has, so far,
forbidden drug companies from peddling prescription products directly to
you. They can market these wares to your MD. Indeed, one American study
observed quite creative forms of direct-to-doctor advertising in the
U.S.: wine-tastings, celebrity autographs and dinner-theatre shows. But
doctors are, ahem, professionals. If the drug firms got direct access to
you, goodness knows what would occur.
Please. We should study how drug advertising can best be done, but to
suppress it is to deny a basic human characteristic: free will. And free
will is not a tangential issue here.
Those who argue for freedom of expression — in this case, the right to
advertise — do so from an inescapable reality: the need to make
choices. Unlike our instinct-based animal friends, we humans do not
survive if we do not choose, and rational choice requires facts; it cannot happen in a data vacuum. The more you suppress information, the more you make
rational choice difficult. Understanding this, it’s hard to argue for
the suppression of information in any field, let alone one as important
as health.
Still, arguments against drug advertising are raised, starting with the
obvious one that the companies will feed us only information that helps
their bottom line.
This is true, just as all interested parties on any topic “spin”
information. But the fact that information may be flawed or incomplete
is actually a powerful argument for ensuring it is widely available. As
difficult as it is to make decisions based on having only some of the facts, how much more difficult if you have none at all? Meanwhile, the wider the
dissemination of the data in question, the more likely its flaws will be
found and exposed.
Drug-ad opponents also argue another, “unique” point: Sick people can’t
make rational decisions. The desperate are vulnerable, and ads may
influence them into demanding inappropriate medication.
My own experience with serious illness convinces me that desperation is
a huge factor in decision-making. But desperate, sick people don’t just
gobble the first pill they see. What they want above all is information,
and our closed health-care system rarely provides it (caring specialists
do, in the limited time they have available).
The situation of the ill vis-Ã -vis drug ads is a bit like that of the
poor vis-Ã -vis casinos. In both cases, vulnerable people are confronted
with “easy-fix” propositions. Except that in the case of the drug ads,
there may be a benefit. And that, with drugs, we can ask doctors and
pharmacists to advise.
The assertion that the vulnerable are in no position to decide is an
argument that, taken to its logical end, says that only those with no
weakness should ever be subjected to advertising. We are imperfect
creatures: our sources are often flawed, our lives less than ideal.
Still we must make choices, and we need data to do so. And, gasp! — we
know drug firms aren’t dispassionate.
But neither is government. A Senate committee studying health care
states that an increase in prescription-drug demand, brought about by
advertising, might cost more. Since the committee is also exploring a
government-run drug plan, it may be more interested in controlling costs
than in allowing informed choices. There are “interests” on all sides.
Let the drug firms advertise. Let everyone examine their claims. They’ll
be no worse than the stuff in my mailbox.
Christina Spencer is the Citizen’s Editorial Pages Editor
